Pommerenke, Forrest A

Pommerenke, Forrest A is an individual health care provider with primary practice located at 4220 Carolina Exchange Dr , Myrtle Beach SC 29579-4220. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Pommerenke, Forrest A can be contacted via phone (843) 663-8013.

Contact Information

Primary practice address
4220 Carolina Exchange Dr Myrtle Beach SC 29579-4220
Fax: (843) 663-8166
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 22630 South Carolina

Profile Details

NPI number 1952331662
LBN Legal business name Pommerenke, Forrest A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952331662 NPPES
South Carolina MEDICAID 226302

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